How Can smoking Affect the Pregnancy and the Baby?

Women who smoke while they are pregnant increase their risk for pregnancy-related complications. Pregnancy places a tremendous burden on a woman’s body. From the fluctuating hormones to the effects of weight gain, even the healthiest woman can develop complications during her pregnancy. Those that smoke are at a greater risk.
Smoking during pregnancy can cause a placental abruption. This occurs when the placenta, the baby’s lifeline during the pregnancy, separates from the uterine wall prior to delivery. The placenta will separate naturally during the labor and delivery process, but when it happens prematurely, the results can be disastrous. When placental separation occurs, it is a life-threatening emergency for both mother and baby.
Not necessarily life-threatening, but still very serious, Placenta Previa is another condition that occurs more frequently in women who smoke during pregnancy. The placenta normally attaches to the side of the uterine wall early in pregnancy. With Placenta Previa, the placenta instead attaches low in the uterus, either partially or completely covering the opening of the uterus. If the opening of the uterus is blocked by the placenta when it is time to deliver the baby, a cesarean section will have to be performed.
Smoking during pregnancy increases the risk of having an ectopic pregnancy. When this occurs, the embryo does not implant in the uterus. Instead, it implants somewhere else, such as the fallopian tubes. When this occurs, the pregnancy must be terminated, as it cannot grow and thrive anywhere other than the uterus. If left untreated, ectopic pregnancy can be life-threatening.
Women who smoke during pregnancy are more likely to experience unexplained vaginal bleeding, and premature delivery. Smoking during pregnancy more than doubles the risk of having a stillbirth.

How Can it Harm the Baby?

Women who smoke during pregnancy are exposing their unborn baby to a myriad of potential health problems both during the pregnancy and after birth. One of the most serious complications is premature delivery. A normal pregnancy lasts for 40 weeks. A baby is considered premature if he is delivered any time before 37 weeks of pregnancy. Women who smoke during pregnancy are up to 4 times more likely to have a baby born before 37 weeks than women who do not smoke. Premature babies are susceptible to a host of health conditions, including difficulty breathing, inability to regulate body temperature and low birth weight.
Babies who are born full term are still at increased risk of having a low birth weight if their mothers smoked during pregnancy, even if they were not delivered prematurely. Premature babies and those that are born with a low birth weight have a much higher chance of developing serious medical conditions, including permanent disabilities, mental retardation, behavioral problems, developmental disabilities and even death.  Babies who are smaller at birth generally have smaller lungs and therefore babies. When this occurs, baby’s first days will likely be spent in a neonatal intensive care unit (NICU) hooked up to breathing tubes or a respirator rather than in his mother’s arms. Even after transitioning out of the NICU, these babies will remain at increased risk for developing asthma and other breathing difficulties later in life.
Babies of mothers who smoked during pregnancy are at increased risk for being born with birth defects such as a cleft palate or cleft lip.
Smoking during pregnancy increases the risk of giving birth to a baby with a heart defect. These babies are up to 70% more likely to have heart defects than babies who were not exposed to smoke while in the womb.
Babies who are born to mothers who smoked during pregnancy are up to 3 times more likely to die from sudden infant death syndrome (SIDS).

How Smoking Affects Your Body And Appearance

At the risk of sounding like a broken record, it is well-known that smoking cigarettes or inhaling secondhand smoke can lead to a myriad of health problems down the line. If you still need convincing, read on to learn about how smoking directly affects different parts of your body and your physical appearance.

Skin

Ironically, while smoking a cigarette may look “cool” when you’re relaxing, it is actually making you less physically attractive with every puff. Studies show that smoking causes premature sagging and wrinkling of the skin, so that smokers can look about 1.5 years older than nonsmokers. Since smoking also decreases the amount of oxygen in the blood, the skin also takes on a gray, ashen tone, replacing the natural glow or blush of healthy skin. It also slows down the wound healing process, so unsightly scars and stretch marks can become more prominent.

Body Weight & Fat

Contrary to popular belief, smoking can actually make you fatter. According to studies conducted by the American Society for Clinical Nutrition, heavy smokers tend to have greater body weight than nonsmokers. Smoking can cause insulin resistance, an important hormone that regulates body fat storage. The fact that smokers cannot breathe smoothly can also lead to a decrease in exercise and a sedentary lifestyle, hence making it difficult to shed pounds.

Lungs

When you inhale a mouthful of cigarette smoke, you are literally killing off the cilia in your airways. Cilia are the hair cells in your throat that helps the airway expel mucus or irritants, so without them, the smoker would be coughing away nonstop at all the mucus buildup in the throat due to the irritants from the smoke. Not only do the risks of esophageal, throat, mouth, and lung cancer increase dramatically, the lung’s ability of getting oxygen for the body also decreases. Lastly, cigarette smoke coats the walls of lungs with tar (yes, the stuff we pave roads with!), and it can take 10 years or for the body to neutralize the substance.

Heart & Blood

Since the lungs cannot get adequate oxygen to flow through the body, the heart works harder to get what little oxygen there is throughout the body. The blood pressure and rate also increases. Elevated CO2 levels in the blood also causes cholesterol deposits on the blood vessel walls, so clotting is more frequent, and the blood becomes stickier and less fluid. Hence, heart attack, stroke, and other life-threatening cardiovascular problems can easily become a reality with smoking.

Hormones

The amount of toxins and carcinogens in cigarette smoking causes the body to go into “alert mode,” which results in internal inflammation everywhere. Stress hormones are secreted from the adrenal glands above the kidneys, increasing the blood pressure (hence the usual jolt of energy smokers receives). Your blood also goes into overdrive to try and rid the body of such toxins. Smoking also messes with insulin, an important metabolic hormone, so it also increases the risk of metabolic syndrome and diabetes.
Sources:

• American Journal of Clinical Nutrition
• Women’s Health magazine
• Ohio State University Medical Center
• MSN – Healthy Living

Wath is Second-hand smoke?

Second-hand tobacco smoke is the smoke emitted from the burning end of a cigarette (also known as ‘side-stream smoke’) or from other tobacco products, in combination with the ‘mainstream smoke’ exhaled by the smoker. Second-hand smoke (SHS) is variously called involuntary smoking, passive smoking and environmental tobacco smoke.
The International Agency for Research on Cancer has declared SHS as carcinogenic.124 Article 8 of the Framework Convention on Tobacco Control (FCTC) focuses on “protection from exposure to tobacco smoke” and signatories to the FCTC have agreed to recognise that “scientific evidence has unequivocally established that exposure to tobacco smoke causes death, disease and disability.” Signatories agreed to adopt effective legislation in order to provide protection from second-hand smoke in indoor workplaces, public transport, indoor public places and, as appropriate, other public places.
In 2002, before the introduction of smoke-free policies, second-hand smoking at work appeared to account for over 7,000 deaths across the EU every year. Second-hand smoking at home appeared to account for 72,000 deaths per year. Since the introduction of smoke-free policies, a Cochrane review by Callinan et al. has found consistent evidence of reduced exposure to SHS in workplaces, restaurants, pubs and in public places. Callinan et al. also found consistent evidence of a reduction in cardiac events as well as some improvement in other health indicators after the introduction of smoke-free legislation. In Scotland, following the introduction of smoke-free legislation covering all enclosed places, hospital admissions for acute coronary syndrome decreased by 17%, compared with only a 4% decrease in England (where the legislation was not in place at the time).
Although 67% of the decrease involved non-smokers, fewer admissions among smokers also contributed to the overall reduction. A study in northern Italy (Piedmont region) reported the number of admissions for acute myocardial infarction (AMI) decreased significantly after the introduction of the smoke-free legislation: from 922 cases in February-June 2004 to 832 cases in February-June 2005 (sex- and age-adjusted rate ratio, 0.89; 95% Confidence Interval (CI) 0.81-0.98 in those aged under 60 years). The authors postulated the effects on AMI admissions might be due to the reduction of passive smoking.
In Italy, after the smoke-free legislation there was a statistically significant reduction in acute coronary events in the adult population, suggesting that public interventions that prohibit smoking can have enormous public health implications.

WHAT IS MENTHOL?

Chemically, menthol is a monocyclic terpene alcohol. It is a naturally occurring chemical chiefly derived from the peppermint plant (Mentha piperita) or the corn mint (Mentha arvensis), but it can also be synthetically produced. The chemical structure of menthol is shown in Figure 1. Menthol can exist as
one of eight stereoisomers—molecules with identical formulas but different three‐dimensional shapes.

These isomers include menthol, isomenthol, neomenthol and neoisomenthol, each of which can exist asl, also called (‐), or d, also called (+). Each of the tereoisomers has distinct pharmacologic characteristics. The l, or (‐), isomer of menthol is the natural isomer and conveys the typical taste and sensory characteristics of menthol. The d, or (+), isomer is active but less so than l‐menthol
.
Tobacco companies use both natural and synthetic menthol in cigarettes. The natural menthol found in cigarettes (l isomer) is typically crystallized from steam‐distilled oil of the corn mint plant. Synthetic menthol (dl ‐ menthol) is racemic, meaning it contains both the d and l isomers and has different taste characteristics from natural menthol. Some cigarette manufacturers use natural menthol only; others use a mixture of natural and synthetic menthol. Natural menthol has been reported to impart greater cooling and mintness and less sharpness, perhaps due to trace chemicals in the natural extract.

Menthol is added to cigarettes in numerous ways:
(1) spraying the cut tobacco during blending;
(2)application to the pack foil;
(3) injection into the tobacco stream in the cigarette maker;
(4) injection into the filter on the filter maker;
(5) insertion of crushable capsule in the filter;
(6) placement of a menthol thread in the filter;
(7) a combination of the above (

Over time, menthol diffuses throughout the cigarette irrespective of where it was applied. Menthol cigarettes are typically blended using more flue‐cured and less burley tobacco. This is because some of the chemicals in burley tobaccos create an incompatible taste character with menthol.

Passive smoking and children

In 2003, over 11,000 people in the UK are estimated to have died as a result of
passive smoking.* Although regarded for many years as little more than a
nuisance, exposure to ambient tobacco smoke released directly by burning
tobacco and indirectly by exhalation of smoke by smokers (also variously
referred to as environmental tobacco smoke, second-hand smoke, or tobacco
smoke pollution) is now a recognised cause of significant short- and long-term
harm to others. Many of those adverse health effects were summarised,
particularly in relation to adult exposure, in an earlier Royal College of
Physicians report.†
Increasing awareness of these health risks has led the UK and several other
countries to introduce legislation restricting or prohibiting smoking in enclosed
public places. This legislation has typically been justified by the legal and moral
obligation to ensure safe working environments and, in the UK, to prevent the
600 or so deaths previously estimated to be caused each year by passive smoking
at work.* However, these are the minority of deaths caused by passive smoking,
the bulk of which (an estimated 10,700 deaths in adults in 2003)* arise from
exposure to tobacco smoke in the home.
Passive smoking in the home is also a major hazard to the health of the
millions of children in the UK who live with smokers, and the extent of this
health problem has not, to date, been accurately quantified. In this report, we
therefore use established literature and additional analysis to estimate the
prevalence, determinants and trends in passive smoking exposure, present new
systematic reviews and meta-analyses of the magnitude of the effects of passive
smoking on the main recognised health consequences in children, and estimate
the numbers of cases of illness and death arising from these effects. We also
quantify the effect of exposure to smoking behaviour on the risk of children
starting to smoke, and estimate the number of children who do take up smoking
as a consequence. We then consider the financial cost of the disease burden for
the NHS and wider society arising from all of these exposures. The report also
explores ethical issues relating to passive smoking and children, and public
opinion on measures to prevent passive smoking, concluding with policy options
that would reduce exposure of children to this significant health hazard and
negative behavioural model.
Governments, and societies, have a duty to ensure that children grow up in a
safe environment, and are protected from explicit or implicit encouragement to
take up hazardous behaviours such as smoking. This report provides some of the
background and policy measures necessary to ensure that that duty is discharged.
I am personally very grateful to John Britton and the other members of the
RCP’s Tobacco Advisory Group, and the many contributors to this report who
have continued the excellent tradition of the RCP in this important area.

Taiwan Children Health Study

The Taiwan Children Health Study (TCHS) has a multipurpose nationwide design, and is focused on common environmental factors such as outdoor pollutants and household ETS exposure. Communities in Taiwan were selected with the aim of maximizing the variability and minimizing the correlations of exposures to outdoor pollutants based on historic routine air monitoring data. In communities with pollution patterns of interest, neighborhoods with stable, largely middle-income populations were identified from 2004 census data.
To address community-level sources of variability, we randomly sought participating communities within existing financial constraints. School district representatives in participating communities were consulted to identify suitable schools, based on demographic stability, likely parental cooperation, and absence of local pollution sources. Our study population finally comprised middleschool children from 14 diverse communities in Taiwan. To permit cross-sectional assessment of environmental factors, we recruited 350-450 participants from each of the study communities. In each classroom targeted for participation, every student was invited to volunteer.
Classroom-level incentives were used to encourage participation. In each school, science, health, or physical education classes were targeted, excluding any special classes for gifted or learning-disabled subjects. The study protocol was approved by the Institutional Review Board at our university hospital, and it complied with the principles outlined in the Helsinki Declaration [28]. Questionnaire of respiratory health A total of 5,804 seventh and eighth-grade children were recruited from public schools in 14 Taiwanese communities in 2007.
The questionnaire was distributed in all communities simultaneously; subjects were given the forms by project staff following their pulmonary function tests and asked to complete and return them the following day. Questionnaire responses by parents or guardians were used to categorize children’s asthma status, age at asthma diagnosis, wheeze, and history of bronchitic symptoms. Children were considered to have asthma if there was a positive answer to the question “Has a doctor ever diagnosed this child as having asthma?” Active asthma was defined as physician-diagnosed asthma with any asthma-related symptoms or illness in the previous 12 months. Serious asthma was defined as ever visit emergency rooms or ever hospitalized. Early-onset asthma was defined as age of onset for asthma before 5 years of age. Late-onset asthma was onset after 5 years of age. Wheeze was defined as any occurrence of the child’s chest sounding wheezy or whistling.
Current wheeze was defined as wheezing for 3 or more days out of the week for a month or longer in the previous year. Bronchitis status was positive if subjects had a physician-diagnosed episode in the prior 12 months. Chronic cough was defined as cough in the morning or at other times of the day that lasted for three months in a row or more during the prior 12 months. Chronic phlegm was defined by a “yes” answer to the question “Other than with colds, does this child usually seem congested in the chest or bring up phlegm?”

The Bigger the Better

Although the above crave episode chart reflects averages of quitter data from a specific
study of a unique population, it shows two factors common to every recovery. It
evidences the fact that the number of daily crave episodes quickly peaks. It also shows
that the number then begins to gradually decline. I’d like to spend a moment focusing
upon natural consequences associated with the decline.
Unless following the bum advice portion of “Clearing the Air” and hiding in a closet in
order to avoid temptation, locked up in prison, or laid up in a hospital room, we have
no choice but to meet and extinguish the bulk of our subconscious feeding cues within
the first week. The number and frequency of early challenges kept us on our toes and
prepared to swing into action and confront challenge on a moment’s notice.
As the crave episode chart a few pages back shows, by the 10th day the average exuser
was experiencing just 1.4 crave episodes per day. That translates to less than five
minutes of significant challenge. But what about the days that follow? What would be
the natural and expected consequences of beginning to go entire days without once
encountering an un-reconditioned crave trigger? What will happen to anticipation, your
preparedness, your defenses and battle plans once you experience a day or two without
serious challenge?
For purposes of discussion only, let’s pretend that during recovery days 14, 15 and 16
that although you remained occupied in dealing with what at times seemed like a
steady stream of conscious thoughts about “wanting” to use nicotine, that you did not
encounter any un-extinguished feeding cues. Although unlikely you’d have noticed,
wouldn't it be normal to begin to relax a bit and slowly lower your defenses and guard?
And then it happens. Assume that on day 17 you encounter a subconscious crave
triggering cue that wasn’t part of normal daily life. It catches you totally unprepared,
off-guard and surprised. You scramble to muster your defenses but it’s as if you can’t
find them, that they too are being swallowed by a fast moving tsunami of rising
anxieties. You feel as if you’ve been sucker-punched hard by the most intense crave
ever. It feels endless. Your conscious thinking mind tells you that things are getting
worse, not better. The thought of throwing in the towel and giving-up suddenly begins
sloshing through a horrified mind.

Stearns could get up to $917,000 to counteract obesity, tobacco

Area public health agencies are anticipating several million in state grant dollars over the next two years to combat obesity and tobacco use, underlying factors in the leading causes of death in Central Minnesota.

The money is part of the Statewide Health Improvement Program passed by the Legislature in 2008 as part of state health care reform. Lawmakers allocated $47 million for the program.

All three St. Cloud-area counties have applied for the program. Sherburne County has been told it will receive $601,000 over the next two years, said Vonna Henry, public health director.

Stearns County could get as much as $917,000, public health director Renee Frauendienst said.

Benton County's amount is still uncertain.

SHIP is modeled on an initiative called Steps to a HealthierUS, which was tested in Minneapolis, St. Paul, Willmar and Rochester.

The goal was to reduce the state's health care costs by getting "upstream" of health problems, said Cara McNulty, program director with the Minnesota Department of Health.

SHIP aims to encourage policy and environmental changes that make it easier for people to make more healthful choices, she said.

The program focuses on obesity and tobacco use because they are both common in Minnesota and the leading causes of chronic diseases such as heart diseases, diabetes and cancer. Many of the deadly diseases driving up health care costs are preventable, McNulty said.

An estimated 38 percent of Minnesota adults are classified as overweight and one quarter are obese as measured by body mass index. Only 51 percent get 30 minutes or more of moderate physical activity five days a week. Eighteen percent of adults smoke.

SHIP is different from past prevention programs because it doesn't just tackle one risk factor in a single setting such as schools, McNulty said. Rather, it involves communities, schools, workplaces and health care systems using strategies proven to work, she said.

Some examples: working with schools to make sure they are providing healthful, affordable breakfasts so students aren't hungry during the day; helping to make communities safer and easier to walk or bike; and promoting farmers markets to make sure the community has access to locally grown fruits and vegetables.

UK tobacco case

LONDON - Six companies will pay a maximum of 173.3 million pounds ($342.5 million) after admitting unlawful practices relating to the retail price of cigarettes in the UK, under a deal with Britain's Office of Fair Trading (OFT).

Japan Tobacco said its Gallaher unit had agreed to pay 93 million pounds for taking part in anti-competitive practices during 2000 to 2003, before the Tokyo-based cigarette group bought the British tobacco company in 2007.

The other five groups, all retailers, were Wal-Mart-owned Asda, First Quench, One Stop Stores (formerly called T&S Stores), Somerfield and TM Retail, a statement by the British regulator said on Friday.

A number of the six parties had previously applied to the OFT for leniency and the total penalties the groups agreed to pay, if all leniency and early resolution discounts are given, is 132.2 million pounds, rather that the pre-discount penalties total of 173.3 million pounds, the OFT said.

The OFT did not say when a final decision on the level of fines would be taken.

The regulator added that supermarket group Sainsbury Plc was the first to apply to the OFT for leniency and will receive complete immunity if it continues to co-operate.

Investigations will continue against Imperial Tobacco Plc, Shell and retailers Morrisons, Morrisons-owned Safeway, Tesco and the Co-operative Group, the OFT said.

Imperial Tobacco said in a statement it had not admitted to any infringement of competition law and had not acted in any way contrary to the interests of consumers. It said it would continue to co-operate with the OFT. (Editing by Mike Elliott and David Holmes)

Menthol Cigarettes

“Opposition to Menthol Cigarettes Grows” (Business Day, June 5) misses the point that the effort to prohibit menthol as a flavoring in cigarettes is but the first leap toward a national ban on all cigarettes.

Almost 30 percent of adult smokers prefer menthol products, meaning millions of Americans would suddenly and arbitrarily be denied their preference of cigarette. They would almost assuredly turn to the black market to obtain the product they want.

History makes clear that prohibitions like this do more harm than good. The failed social experiment of alcohol prohibition is a good lesson. There is ample evidence that criminal enterprises and terrorist organizations already find the profit from black market cigarettes easy to generate and conceal. And that’s when the product is legal everywhere, and the only differences in availability are the taxes from one jurisdiction to another.

It is inevitable that this problem will be worsened if an outright ban were put in place.

Depriving thousands of hard-working Americans — mom-and-pop convenience stores, tobacco farmers and everyone else in small companies that support the manufacture of menthol cigarettes — of 30 percent of their business would be disastrous.

Coupled with the fact that the scientific research to date is inconclusive as to whether menthol products are any better or worse than nonmenthol products, it is clear that the advocated ban on menthol cigarettes is misguided and has the very real potential to harm our national and economic security.

Hey Where Are All The Cigarettes?

Toronto - Thanks to a new law, which came into effect over the weekend, cigarettes are no longer visible to customers at stores across Ontario.

The new law requires stores to keep the packages out of view.

“This marketing tool … is a wall of temptation for smokers who have made the decision to quit,” said Joanne Di Nardo, spokeswoman for the Ontario Tobacco-Free Network. “Well-documented research and evidence shows that these retail display stands increase tobacco sales by 12 percent to 28 percent.”

When asked how it has effected sales so far, one store in Toronto told EON, “oh…people just laugh….hasn’t stopped anyone from buying their smokes.”

Other provinces are expected to implement a similiar program

Fire-Safe Cigarettes Will Prevent Fires

HONOLULU -- The Honolulu Fire Department said it is already looking forward to next year, when a new law kicks in aimed to making cigarettes less likely to start fires.
KITV's Shayne Enright reported that a home in Kapolei was destroyed last year by a cigarette thrown in the trash.
One person was injured and a family was left without a home.
The HFD said it hopes to avoid incidences like that when the new law is enacted.
"Actually, what we want to do is put ourselves out of business if we can prevent a fire. Not only do we help the community, but we also help the responders," said HFD Chief Kenneth Silva.
The new cigarettes have bands of paper that have a higher density, and if a cigarette is left unattended, it will self-extinguish, Enright said.
Lawmakers said cigarette manufactures support the safety measure, and smokers shouldn't expect to pay higher costs, they said.
"When the fires came through, it shut down our only highway that we have, stranding tons of visitors and residents who couldn't get to the airport," said Rep. Angus McKelvey. "The thing grew out of control so fast, and a lot of it could have been prevented."
A large brushfire last year in Lahaina prompted Maui officials to take action.
Some smokers said fire-safe cigarettes will prevent fires from starting.
"Normally I try to avoid smoking in the bedroom and places like that, and you try to keep an eye on it. It could be potential danger -- you never know what happens," smoker Bart Van Kerkhove.
The special cigarettes show up on store shelves in September 2009, Enright said.